Zyban Warnings and Precautions (Cont.)

• Antidepressants (including Zyban) may increase the risk of suicidal thinking or behavior (see Antidepressants and Suicide or Zyban and Suicide). Therefore, if you notice any changes in symptoms or new symptoms while taking Zyban, be sure to talk with your healthcare provider immediately. Some of these symptoms may include:
   
  • Anxiety
  • Hostility
  • Agitation
  • Panic
  • Restlessness
  • Hallucinations
  • Extreme hyperactivity
  • Suicidal thoughts or behavior.

• Before prescribing Zyban, your healthcare provider should make sure that you do not have bipolar disorder, as the medication can cause problems in people with this condition.
   
• Zyban can increase the risk of seizures (see Zyban Seizures). Because of this, there are certain people who should not take Zyban, including people with:
   
  • Seizure disorders
  • Bulimia or anorexia
  • Brain trauma or brain injury
  • Severe liver cirrhosis.

Also, people taking certain medications (see Zyban Drug Interactions) have a higher risk of seizures. Abruptly stopping alcohol or sedative medications can also increase your chance of seizures.

• To avoid seizures, you should not take more than 300 mg of Zyban per day, and each individual dose should not be greater than 150 mg (see Zyban Dosage).
   
• Zyban should not be used right after a heart attack. Also, there is some evidence that the drug can cause irregular heart rhythms (arrhythmias) in people with heart disease.
   
• Since the liver and kidneys help to clear Zyban in the blood, you should talk with your healthcare provider before taking Zyban if you have liver or kidney problems.
   
• Zyban can cause insomnia, agitation, hallucinations, confusion, and other mental problems, especially in people just starting treatment with the medicine. Tell your healthcare provider if you are experiencing any of these problems.
   
• Zyban can cause high blood pressure (hypertension), especially in people using nicotine patches at the same time as they are taking Zyban. Your healthcare provider should monitor your blood pressure if you are taking Zyban along with nicotine patches. It is not known if the drug causes problems in people who have heart disease or who have recently had a heart attack.
   
• Zyban is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Talk with your healthcare provider about the risks and benefits of using Zyban during pregnancy (see Zyban and Pregnancy).
   
• Zyban passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to beginning treatment with Zyban.